Daniel F Kupsky1, Amjad M Ahmed2, Sherif Sakr2, Waqas T Qureshi3, Clinton A Brawner1, Michael J Blaha4, Jonathan K Ehrman1, Steven J Keteyian1, Mouaz H Al-Mallah5. 1. Heart and Vascular Institute, Henry Ford Hospital System, Detroit, MI. 2. King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King AbdulAziz Cardiac Center, Ministry of National Guard, Health Affairs, Riyadh, Kingdom of Saudi Arabia. 3. Wake Forest University, Winston Salem, NC. 4. Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD. 5. Heart and Vascular Institute, Henry Ford Hospital System, Detroit, MI; King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King AbdulAziz Cardiac Center, Ministry of National Guard, Health Affairs, Riyadh, Kingdom of Saudi Arabia. Electronic address: mouaz74@gmail.com.
Abstract
BACKGROUND: Prior studies have demonstrated cardiorespiratory fitness (CRF) to be a strong marker of cardiovascular health. However, there are limited data investigating the association between CRF and risk of progression to heart failure (HF). The purpose of this study was to determine the relationship between CRF and incident HF. METHODS: We included 66,329 patients (53.8% men, mean age 55 years) free of HF who underwent exercise treadmill stress testing at Henry Ford Health Systems between 1991 and 2009. Incident HF was determined using International Classification of Diseases, Ninth Revision codes from electronic medical records or administrative claim files. Cox proportional hazards models were performed to determine the association between CRF and incident HF. RESULTS: A total of 4,652 patients developed HF after a median follow-up duration of 6.8 (±3) years. Patients with incident HF were older (63 vs 54 years, P<.001) and had higher prevalence of known coronary artery disease (42.3% vs 11%, P<.001). Peak metabolic equivalents (METs) of task were 6.3 (±2.9) and 9.1 (±3) in the HF and non-HF groups, respectively. After adjustment for potential confounders, patients able to achieve ≥12 METs had an 81% lower risk of incident HF compared with those achieving <6 METs (hazard ratio 0.19 [95% CI 0.14-0.29], P for trend < .001). Each 1 MET achieved was associated with a 16% lower risk (hazard ratio 0.84 [95% CI 0.82-0.86], P<.001) of incident HF. CONCLUSIONS: Our analysis demonstrates that higher level of fitness is associated with a lower incidence of HF independent of HF risk factors.
BACKGROUND: Prior studies have demonstrated cardiorespiratory fitness (CRF) to be a strong marker of cardiovascular health. However, there are limited data investigating the association between CRF and risk of progression to heart failure (HF). The purpose of this study was to determine the relationship between CRF and incident HF. METHODS: We included 66,329 patients (53.8% men, mean age 55 years) free of HF who underwent exercise treadmill stress testing at Henry Ford Health Systems between 1991 and 2009. Incident HF was determined using International Classification of Diseases, Ninth Revision codes from electronic medical records or administrative claim files. Cox proportional hazards models were performed to determine the association between CRF and incident HF. RESULTS: A total of 4,652 patients developed HF after a median follow-up duration of 6.8 (±3) years. Patients with incident HF were older (63 vs 54 years, P<.001) and had higher prevalence of known coronary artery disease (42.3% vs 11%, P<.001). Peak metabolic equivalents (METs) of task were 6.3 (±2.9) and 9.1 (±3) in the HF and non-HF groups, respectively. After adjustment for potential confounders, patients able to achieve ≥12 METs had an 81% lower risk of incident HF compared with those achieving <6 METs (hazard ratio 0.19 [95% CI 0.14-0.29], P for trend < .001). Each 1 MET achieved was associated with a 16% lower risk (hazard ratio 0.84 [95% CI 0.82-0.86], P<.001) of incident HF. CONCLUSIONS: Our analysis demonstrates that higher level of fitness is associated with a lower incidence of HF independent of HF risk factors.
Authors: Stephen J Foulkes; Erin J Howden; Yoland Antill; Sherene Loi; Agus Salim; Mark J Haykowsky; Robin M Daly; Steve F Fraser; Andre La Gerche Journal: BMC Cancer Date: 2020-07-14 Impact factor: 4.430
Authors: Jasper Tromp; Samantha M A Paniagua; Emily S Lau; Norrina B Allen; Michael J Blaha; Ron T Gansevoort; Hans L Hillege; Douglas E Lee; Daniel Levy; Ramachandran S Vasan; Pim van der Harst; Wiek H van Gilst; Martin G Larson; Sanjiv J Shah; Rudolf A de Boer; Carolyn S P Lam; Jennifer E Ho Journal: BMJ Date: 2021-03-23
Authors: Hayley T Dillon; Nicholas J Saner; Tegan Ilsley; David Kliman; Andrew Spencer; Sharon Avery; David W Dunstan; Robin M Daly; Steve F Fraser; Neville Owen; Brigid M Lynch; Bronwyn A Kingwell; Andre La Gerche; Erin J Howden Journal: BMC Cancer Date: 2022-08-17 Impact factor: 4.638
Authors: Neela D Thangada; Kershaw V Patel; Bradley Peden; Vijay Agusala; Julia Kozlitina; Sonia Garg; Mark H Drazner; Colby Ayers; Jarett D Berry; Ambarish Pandey Journal: J Am Heart Assoc Date: 2021-02-22 Impact factor: 5.501